PCN103 Cost-Effectiveness Analysis of Trastuzumab Emtansine for Adjuvant Treatment of Adult Patients with HER2+ EARLY Breast Cancer in Turkey

Abstract

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-related deaths in women. HER2+ breast cancer is an aggressive disease, which affects women in the earlier stages of life and results in substantial burden on patients, healthcare systems and society. Trastuzumab emtansine targets HER2+ tumor cells, delivering cytotoxic DM1 to HER2-expressing cells. The aim of this study is to demonstrate the cost effectiveness (CE) of trastuzumab emtansine compared with trastuzumab for the adjuvant treatment of residual invasive HER2+ eBC from the perspective of the Social Security Institution (payer) in Turkey. In the CE model, a six health state Markov model developed to compare trastuzumab emtansine with trastuzumab. The probabilistic Markov model is constructed using monthly cycle to explore the health outcomes and costs associated with the adjuvant treatment of patients with residual invasive HER2+ eBC after completion of preoperative systemic treatment. All utility values are age and gender adjusted to ensure that QALY estimate is line with the general population. Time horizon is 50 years. All costs including drug, supportive care, administration and adverse events based on public paid (SUT) prices. Discount rate of 3.5% applied for utilities & costs. The main model outcome is determined according to the incremental cost-effectiveness ratio (ICER) based on the quality-adjusted life years (Life Years LY). The analysis shows that the incremental benefit offered by trastuzumab emtansine is 1.606 QALYs (LY: 1.981) with an incremental cost of 11,183TRY (LY: 9,068TRY) when compared to trastuzumab. For eBC treatment and compared with trastuzumab, trastuzumab emtansine is a very cost-effective option when ICER is evaluated. Sensitivity analysis suggest that model is most sensitive to the treatment duration. Probabilistic sensitivity analyses show that results are stable.